Trending Articles
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The reliability and validity of a German version (MPI-D) of the West Haven-Yale Multidimensional Pain Inventory (WHYMPI) was assessed in a sample of 185 chronic pain patients. MPI-D shows high internal consistency, valid subscales, and a factor structure that is comparable to the American version. The Interference scale of part 1 includes an additional item and one other item was excluded; the Life Control scale had one item added. ⋯ The questionnaire is sensitive to therapeutic change. The German scale means are lower for the scales indicating more disturbance or severity and higher for the scales indicating less disturbance. It is not clear whether this reduced pain impact is characteristic of German pain patients in general, or whether it is due to the less severely affected sample tested in this study.
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Clinical Trial Controlled Clinical Trial
Safety of implantation of a cardioverter-defibrillator without general anesthesia in an electrophysiology laboratory.
Implantable cardioverter-defibrillators (ICDs) have conventionally been implanted in an operating room under general anesthesia. This study was performed to evaluate ICD implantation without general anesthesia by 2 electrophysiologists in an electrophysiology laboratory. Between February and September 1994, 27 consecutive patients (22 men and 5 women, mean age 59 +/- 15 years) who underwent ICD implantation by 2 electrophysiologists were included in this study. ⋯ Mean time from implantation to discharge was 2.5 +/- 2.1 days. During late follow-up (n = 23; mean 12.4 +/- 5.8 weeks), all devices were functioning appropriately. In conclusion, this report demonstrates that ICD implantation can be successfully and safely performed by a team of 2 electrophysiologists using local anesthesia and intravenous sedation.(ABSTRACT TRUNCATED AT 250 WORDS)
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Semin Respir Crit Care Med · Aug 2019
ReviewPharmacokinetics/Pharmacodynamics of β-Lactams and Therapeutic Drug Monitoring: From Theory to Practical Issues in the Intensive Care Unit.
Despite therapeutic advances over recent decades, the mortality rate for sepsis and septic shock is still approximately 25% worldwide. Early administration of appropriate intravenous antibiotics in the right dose is one of the cornerstones of treatment of sepsis. β-Lactam antibiotics are the most commonly prescribed in critically ill patients, and dosages that do not achieve specific pharmacokinetic/pharmacodynamic targets may increase the likelihood of treatment failure and even emergence of antibiotic resistance. Fluctuations in physiological parameters are often observed in critically ill patients, leading to altered pharmacokinetics and increased risk of suboptimal exposures, especially if standard dosing according to the product information is prescribed. ⋯ This review will investigate alternative β-lactam dose optimization strategies including prolonged infusions, guideline-based dosing, therapeutic drug monitoring (TDM), and the use of dose optimization software, all of which aim to increase the likelihood of achieving therapeutic drug concentrations and improve clinical outcomes as compared with the standard dosing approach. These dose optimization strategies have been the subject of a growing body of evidence; however, further investigation into the outcome benefits and validity of both non-TDM and TDM dosing strategies is required. For the clinician, it is important to select a feasible dosing strategy tailored for the individual patient, which will maximize the likelihood of achieving therapeutic concentrations at steady state and maintain these exposures throughout the course of therapy.
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Nan Fang Yi Ke Da Xue Xue Bao · Aug 2014
[Minimally invasive treatment of Gartland type III humerus supracondylar fracture in children].
To explore minimally invasive surgical techniques for Gartland type III humeral supracondylar fracture in children and evaluate the outcomes of the patients. ⋯ The minimally invasive method with closed reduction and percutaneous pinning internal fixation is feasible for treatment of Gartland type III humerus condyle fracture in children. This approach involves relatively simple operation with shorter operation time, minimal trauma, and less complications after operation, and promotes early functional recovery of the elbow joint.
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Review Meta Analysis
Comparison of preoperative hair removal methods for the reduction of surgical site infections: a meta-analysis.
To evaluate the efficacy of different methods of preoperative hair removal in reducing surgical site infections. ⋯ Preoperative hair removal should be avoided unless necessary. When it is necessary to remove hair, the existing evidence suggests that clipping is more effective in reducing surgical site infections than shaving or depilatory cream.